应用锥形束CT诊断上颌埋伏尖牙造成的切牙根吸收  

Application of Cone Beam Computed Tomography for Diagnosis of Incisor Root Resorption Caused by Impacted Maxillary Canine

作　　者：田玉楼[1] 刘芳[1] 吕品[1] 韩坤[1] 赵修良[2] 刘明[2] 

机构地区：[1]中国医科大学口腔医学院正畸科,辽宁省口腔医学研究所正畸学研究室,沈阳110002 [2]中国医科大学口腔医学院放射线科,沈阳110002

出　　处：《中国医科大学学报》2013年第11期1043-1047,共5页Journal of China Medical University

摘　　要：目的探讨锥形束CT(CBCT)在诊断上颌埋伏阻生尖牙造成的邻近切牙根吸收中的临床应用。方法选择经曲面平展片确定有上颌埋伏尖牙,但无法判定其整体位置及是否造成切牙根吸收情况的患者36例,行CBCT扫描和三维重建,并制作出相应的矢状向、冠状向、轴状向等不同轴位的二维图像,确定埋伏尖牙在上颌骨中的位置、与切牙的位置关系、是否对切牙造成根吸收及根吸收程度。结果 36例患者的41颗埋伏尖牙经CBCT确切诊断出19颗(46.4%)于唇侧阻生、16颗(39.0%)于腭侧阻生、6颗(14.6%)阻生于牙槽骨中央;41颗埋伏尖牙中33颗(80.5%)造成了不同程度的邻近切牙牙根吸收,其中15颗(36.6%)埋伏尖牙只造成侧切牙根吸收,6颗(14.6%)仅造成中切牙根吸收,12颗(29.3%)造成中切牙和侧切牙根均发生吸收,另外8颗(19.5%)未造成邻近切牙根吸收。结论埋伏尖牙容易造成邻近切牙的牙根吸收,应当引起正畸医生的高度重视。应用CBCT能够客观地显示上颌埋伏尖牙的空间位置以及对邻牙造成的根吸收情况,为临床诊断和治疗方案的制定提供可靠的影像学依据。Objective To investigate the chnical application of cone beam computed tomography （CBCT） in diagnosis of incisor root resorption caused by impacted maxillary canine. Methods A total of 36 patients with 41 maxiIlmy impacted canines on panoramic radiographs were recruited for the study.The location of the impacted maxillary canines and the root resorption of adiacent teeth were unclear among these subjects. The impacted maxillary canines were scanned by CBCT, and then the three-dimensional images were obtained by multiplanar reconstructions （ MPR ） and the two- dimensional images including sagittal, coronal and axial planes, which were used to derermine the location of impacted canines and the root resorp- tion of adjacent incisors. Results Among the 41 maxillary impacted canines, 19 （46.4%） maxillary canines were impacted labially, 16 （39.0%） were impacted palatally, and 6 （ 14.6% ） were impacted in the midalveolus. Moreover, varying degrees of root resorption in adjacent incisors were ob- served in 33 （80.5%） impacted canines, including 15 cases （36.6%） of lateral incisors, 6 cases （14.6%） of central incisors and 12 cases （29.3%） of lateral and central incisors. No root resorption of adjacent incisors was found in 8 ca.,~es （ 19.5% ）. Conclusion Impacted canines likely to cause root resorption of adjacent incisors, which should amuse the attention of orthodontists. CBCT can objectively display the location of impacted canines and the root resorption of adjacent incisors, which provides dependable information for cinical diagnosis and treatments.

关 键 词：上颌尖牙 埋伏阻生 锥形束CT 切牙 牙根吸收 

分 类 号：R783.5[医药卫生—口腔医学]